1
|
Robb KA, Green LA, Perry SD. The use of textured foot orthoses to facilitate cutaneous afferent input during walking. Neurosci Lett 2024; 818:137566. [PMID: 37996050 DOI: 10.1016/j.neulet.2023.137566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Revised: 10/12/2023] [Accepted: 11/20/2023] [Indexed: 11/25/2023]
Affiliation(s)
- Kelly A Robb
- Department of Kinesiology and Physical Education, Faculty of Science, Wilfrid Laurier University, 75 University Ave. West, Waterloo, ON, CANADA N2L 3C5, Canada.
| | - Lara A Green
- Department of Kinesiology and Physical Education, Faculty of Science, Wilfrid Laurier University, 75 University Ave. West, Waterloo, ON, CANADA N2L 3C5, Canada.
| | - Stephen D Perry
- Department of Kinesiology and Physical Education, Faculty of Science, Wilfrid Laurier University, 75 University Ave. West, Waterloo, ON, CANADA N2L 3C5, Canada.
| |
Collapse
|
2
|
Hatton AL, Williams K, Chatfield MD, Hurn S, Maharaj JN, Gane EM, Cattagni T, Dixon J, Rome K, Kerr G, Brauer SG. Effects of wearing textured versus smooth shoe insoles for 12 weeks on gait, foot sensation and patient-reported outcomes, in people with multiple sclerosis: a randomised controlled trial. BRAIN IMPAIR 2023; 24:148-167. [PMID: 38167196 DOI: 10.1017/brimp.2022.33] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Abstract
BACKGROUND Innovative shoe insoles, designed to enhance sensory information on the plantar surface of the feet, could help to improve walking in people with Multiple Sclerosis. OBJECTIVE To compare the effects of wearing textured versus smooth insoles, on measures of gait, foot sensation and patient-reported outcomes, in people with Multiple Sclerosis. METHODS A prospective, randomised controlled trial was conducted with concealed allocation, assessor blinding and intention-to-treat analysis. Thirty ambulant men and women with multiple sclerosis (MS) (Disease Steps rating 1-4) were randomly allocated to wear textured or smooth insoles for 12 weeks. Self-reported insole wear and falls diaries were completed over the intervention period. Laboratory assessments of spatiotemporal gait patterns, foot sensation and proprioception, and patient-reported outcomes, were performed at Weeks 0 (Baseline 1), 4 (Baseline 2) and 16 (Post-Intervention). The primary outcome was the size of the mediolateral base of support (stride/step width) when walking over even and uneven surfaces. Independent t-tests were performed on change from baseline (average of baseline measures) to post-intervention. RESULTS There were no differences in stride width between groups, when walking over the even or uneven surfaces (P ≥ 0.20) at post-intervention. There were no between-group differences for any secondary outcomes including gait (all P values > 0.23), foot sensory function (all P values ≥ 0.08) and patient-reported outcomes (all P values ≥ 0.23). CONCLUSIONS In our small trial, prolonged wear of textured insoles did not appear to alter walking or foot sensation in people with MS who have limited foot sensory loss. Further investigation is needed to explore optimal insole design. CLINICAL TRIAL REGISTRATION Australian and New Zealand Clinical Trials Registry (ACTRN12615000421538).
Collapse
Affiliation(s)
- Anna L Hatton
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Katrina Williams
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Mark D Chatfield
- Centre for Health Sciences Research, The University of Queensland, Brisbane, Australia
| | - Sheree Hurn
- School of Clinical Sciences, Queensland University of Technology, Brisbane, Australia
| | - Jayishni N Maharaj
- School of Allied Health Sciences, Griffith University, Gold Coast, Australia
| | - Elise M Gane
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| | - Thomas Cattagni
- Laboratory Movement, Interactions, Performance EA 4334, University of Nantes, Nantes, France
| | - John Dixon
- School of Health & Social Care, Teesside University, Middlesbrough, UK
| | - Keith Rome
- School of Clinical Sciences, Auckland University of Technology, Auckland, New Zealand
| | - Graham Kerr
- Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia
| | - Sandra G Brauer
- School of Health and Rehabilitation Sciences, The University of Queensland, Brisbane, Australia
| |
Collapse
|
3
|
Robb KA, Howe EE, Perry SD. The effects of foot orthoses and sensory facilitation on lower limb electromyography: A scoping review. Foot (Edinb) 2022; 52:101904. [PMID: 36049264 DOI: 10.1016/j.foot.2022.101904] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/22/2021] [Revised: 10/22/2021] [Accepted: 01/03/2022] [Indexed: 02/04/2023]
Abstract
Foot orthoses (FO) are used as a treatment for biomechanical abnormalities, overuse injuries, and neuropathologies, but study of their mechanism remains inconclusive. The neuromotor paradigm has proposed that FOs may manipulate sensory input from foot sole skin to reduce muscle activity for movement optimization. This review argues that a FO likely alters the incoming mechanical stimuli transmitted via cutaneous mechanoreceptors and nociceptors as the foot sole interfaces with the surface of the orthotic. Thus, all FOs with or without intentional sensory facilitation, likely changes sensory information from foot sole cutaneous afferents. Additionally, in light of understanding and applying knowledge pertaining to the cutaneous reflex loop circuitry, FO's increasing sensory input to the motorneuron pool can change EMG to either reflex sign (increase or decrease). The purpose of this scoping review was to synthesize FO and sensory augmentation literature and summarize how FO designs can capitalize on foot sole skin to modulate lower limb electromyography (EMG). Six database searches resulted in 30 FO studies and 22 sensory studies that included EMG as an outcome measure. Results revealed task and phase specific responses with some consistencies in EMG outcomes between testing modalities, however many inconsistencies remain. Electrical stimulation reflex research provides support for a likely sensory-to-motor factor contributing to muscle activity modulation when wearing FOs. The discussion divides trends in FO treatment modalities by desired increase or decrease in each compartment musculature. The results of this review provides a benchmark for future academics and clinicians to advance literature in support of a revised neuromotor paradigm while highlighting the importance of foot sole skin in FO design.
Collapse
Affiliation(s)
- Kelly A Robb
- Department of Kinesiology and Physical Education, Faculty of Science, Wilfrid Laurier University, 75 University Ave. West, Waterloo, ON N2L 3C5, Canada.
| | - Erika E Howe
- Department of Human Health and Nutritional Sciences, University of Guelph, 50 Stone Road East, Guelph, ON N1G 2W1, Canada.
| | - Stephen D Perry
- Department of Kinesiology and Physical Education, Faculty of Science, Wilfrid Laurier University, 75 University Ave. West, Waterloo, ON N2L 3C5, Canada.
| |
Collapse
|
4
|
Palazzo F, Lamouchideli N, Caronti A, Tufi F, Padua E, Annino G. Neuromuscular response to the stimulation of plantar cutaneous during walking at different speeds. Gait Posture 2022; 95:84-92. [PMID: 35462053 DOI: 10.1016/j.gaitpost.2022.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2021] [Revised: 03/18/2022] [Accepted: 04/02/2022] [Indexed: 02/02/2023]
Abstract
BACKGROUND A lot of authors have been studied the consequence of postural control strategies through investigating the effects of foot-surface contact. In this context an important variable of textured surfaces or insoles could be related to material stiffness. We apply a particular textured insoles to evaluate neuromuscular response of plantar stimulation during walking. RESEARCH QUESTION Could textured insoles alter the human locomotion during walking at different speeds? METHODS Ten adults (age: 27 ± 5 years) completed three trials on the multifunction treadmill at 0.42 ms-1, 0.89 ms-1, and 1.5 ms-1 walking speed. Temporal-spatial parameters, gait line, and kinetic parameters were analyzed. The Co-Contraction Index (CCI) and electromyography (EMG) of the right leg muscles were assessed during four phases of gait: first half stance (FHS), half stance (HS), second half stance (SHS), swing phase (SP). Textured insole and soft control insole were worn while walking. RESULTS Plantar stimulation improved cadence, stride time, stride length and gait line parameters with increasing speed. First force peaks and maximum force forefoot were always significant. The maximum force midfoot was significant at 0.42 and 0.89 ms-1. The maximum force heel only was significant in lower velocity. The maximum pressure showed different significant values except for the heel. Significant differences in the CCI were always found in the FHS and SHS for the plantar muscles, and in the FHS and HS for the knee muscles. The differences in gait analysis in biomechanical and in electromyographic parameters were more significant in the higher speed tested. SIGNIFICANCE The perception of shape and texture through its linear response to skin deformation over a wide range of deformations could be the reason why the significant differences increase in the higher speed. In conclusion, sensory interventions fallowing appropriate insoles can influence significantly gait. Walking strategy positively adjusts locomotion with high efficiency.
Collapse
Affiliation(s)
- Francesco Palazzo
- School of Human Movement Science, Faculty of Medicine and Surgery, University of Rome ''Tor Vergata'', Rome, Italy.
| | - Niloofar Lamouchideli
- Department of Human Neuroscience, Faculty of Medicine and Dentistry, Sapienza University of Rome, Italy
| | - Alfio Caronti
- School of Human Movement Science, Faculty of Medicine and Surgery, University of Rome ''Tor Vergata'', Rome, Italy
| | - Fabrizio Tufi
- School of Human Movement Science, Faculty of Medicine and Surgery, University of Rome ''Tor Vergata'', Rome, Italy
| | - Elvira Padua
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Italy
| | - Giuseppe Annino
- Department of Human Sciences and Promotion of the Quality of Life, San Raffaele Roma Open University, Italy; Department of Medicine Systems, University of Rome ''Tor Vergata'', Rome, Italy; Centre of Space Bio-Medicine, "Tor Vergata" University of Rome, Rome, Italy
| |
Collapse
|
5
|
Ravanbod R, Eslami N, Ashtiani MN. Immediate effects of footwear with vibration applied to the swing phase of the gait cycle on dynamic balance in patients with diabetic peripheral neuropathy. J Biomech 2021; 128:110710. [PMID: 34474373 DOI: 10.1016/j.jbiomech.2021.110710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 08/16/2021] [Accepted: 08/23/2021] [Indexed: 11/25/2022]
Abstract
Sensory and sub-sensory foot vibration have beneficial effects on the static and dynamic balance of patients with diabetic peripheral neuropathy (DPN). Previous foot vibration during walking was applied at sub-sensory threshold in both stance and swing phases of the gait cycle in DPN. This study aimed to investigate the effects of footwear with vibration above the sensory threshold applied to the swing phase of the gait cycle on the dynamic balance of DPN. Fifteen patients with DPN and 10 matched healthy control participants were enrolled in this study. Dynamic balance assessment was investigated by the sit to stand and turn tests while electromyography activity (root mean square, RMS) of the vastus lateralis (VL), tibialis anterior (TA), and peroneus longus (PL) muscles were recorded at baseline, after 10 min of wearing the vibratory sandal without vibration, and after 10 min of wearing the sandal with vibration. Repeated measure analysis of variance was conducted for data analysis. Wearing the vibratory sandal slightly increased the speed of weight transfer in both groups and COP sway in DPN (P > 0.05), and close to significant decrease of turn sway (P = 0.07) in both groups. There were significant differences of the PL RMS in turn test (P = 0.03) in DPN and peak RMS of the PL after 10 min of wearing the sandal with vibration in both groups (P < 0.05). The results of the present study demonstrated that PL activity was significantly influenced by the vibratory sandal as its tendon passing across the sole and in direct contact with the source of the vibration.
Collapse
Affiliation(s)
- Roya Ravanbod
- Department of Physiotherapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14115-111, Iran.
| | - Niloofar Eslami
- Department of Physiotherapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14115-111, Iran
| | - Mohammed N Ashtiani
- Department of Physiotherapy, Faculty of Medical Sciences, Tarbiat Modares University, Tehran 14115-111, Iran
| |
Collapse
|
6
|
Robb KA, Hyde JD, Perry SD. The role of enhanced plantar-surface sensory feedback on lower limb EMG during planned gait termination. Somatosens Mot Res 2021; 38:146-156. [PMID: 33789527 DOI: 10.1080/08990220.2021.1904870] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
Purpose/aim of the study: Generation of smooth movement relies on the central nervous system (CNS) having information from the visual, vestibular and somatosensory systems to effectively execute motor behaviour. Recently, cutaneous afferent inputs have been linked to lower leg motorneuron pools, resulting in a growing interest of adding texture to the plantar foot sole interface as a novel method to facilitate cutaneous feedback. The aim of this study was to characterize the changes in magnitude and temporal organization of muscle activity, and to investigate motor output changes from enhanced tactile feedback during perturbed gait termination.Materials and methods: Thirty young adults experienced an unpredictable platform perturbation when completing planned gait termination. The study manipulated two experimental variables: 1) direction of platform tilt (anterior, posterior, medial, lateral), and 2) foot sensory facilitation (non-facilitated, facilitated). Upper and lower leg EMG onset, cessation time and integrated EMG (iEMG) were measured in addition to common gait parameters (walking velocity, step length, step width).Results: Gait termination over a textured surface resulted in significantly earlier upper leg EMG onset times and modified iEMG of rectus femoris, vastus medialis and biceps femoris muscles.Conclusions: Results of this study suggest that the addition of cutaneous feedback under the plantar-surface of the foot increases the ability to generate an earlier muscle response, consequently improving response ability to an unexpected perturbation. Secondly, enhanced tactile feedback appears to inform the CNS of the magnitude of the threat to the balance control system, providing additional insight into how the CNS uses enhanced tactile feedback during a gait termination task.
Collapse
Affiliation(s)
- Kelly A Robb
- Department of Kinesiology and Physical Education, Faculty of Science, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Jordan D Hyde
- Department of Kinesiology and Physical Education, Faculty of Science, Wilfrid Laurier University, Waterloo, ON, Canada
| | - Stephen D Perry
- Department of Kinesiology and Physical Education, Faculty of Science, Wilfrid Laurier University, Waterloo, ON, Canada
| |
Collapse
|
7
|
Chang HY, Chang YC, Cheng SC, Wang CH. The effectiveness of rearfoot medial wedge intervention on balance for athletes with chronic ankle instability. Medicine (Baltimore) 2019; 98:e16217. [PMID: 31261576 PMCID: PMC6617356 DOI: 10.1097/md.0000000000016217] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
BACKGROUND Athletes with chronic ankle instability (CAI) often develop complications such as pain, instability, and reduced postural control and balance stability, all of which affect athletic performance. This study investigated the effects of a 4° medal wedge intervention on static and dynamic balance in athletes with CAI. METHODS The participants were 24 healthy and 25 CAI athletes. Participants received a 4° medial wedge applied at the rear foot insole and completed the experiment measurements before and after the wedge intervention. The main outcome measures included the area and path length of the center of pressure when participants performed single-leg standing balance in the closed eye condition and the dynamic balance scores of a multiple single-leg hop stabilization test. RESULTS The single-leg standing balance significantly improved in CAI (P = .027) and control groups (P = .005) after the medial wedge intervention. The dynamic balance scores significantly decreased from 53.00 ± 25.22 to 41.24 ± 21 48 (P = .015) in CAI group after medial wedge intervention. CONCLUSION Wearing a 4° medial wedge applied at the rear foot insole improved static and dynamic balance immediately in athletes with CAI. We suggest that clinicians may provide the foot insole to improve balance deficit in athletes having CAI.
Collapse
Affiliation(s)
- Hsiao-Yun Chang
- Department of Athletic Training and Health, National Taiwan Sport University, Taoyuan
| | - Yun-Chi Chang
- Department of Physical Therapy and Assistive Technology, National Yang-Ming University, Taipei
| | - Shih-Chung Cheng
- Graduate Institute of Athletics and Coaching Science, National Taiwan Sport University, Taoyuan
| | - Chun-Hou Wang
- Department of Physical Therapy, Chung Shan Medical University, and Physical Therapy Room, Chung Shan Medical University Hospital, Taichung, Taiwan
| |
Collapse
|
8
|
Gorst T, Freeman J, Yarrow K, Marsden J. Assessing Plantar Sensation in the Foot Using the Foot Roughness Discrimination Test (FoRDT): A Reliability and Validity Study in Stroke. PM R 2019; 11:1083-1092. [PMID: 30690894 DOI: 10.1002/pmrj.12085] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2018] [Accepted: 12/11/2018] [Indexed: 11/06/2022]
Abstract
BACKGROUND The plantar foot represents a sensory dynamometric map and is essential for balance and gait control. Sensory impairments are common, yet often difficult to quantify in neurological conditions, particularly stroke. A functionally oriented and quantifiable assessment, the Foot Roughness Discrimination Test (FoRDT), was developed to address these shortcomings. OBJECTIVE To evaluate inter- and intrarater reliability, convergent and discriminant validity of the FoRDT. DESIGN Test-retest design. SETTING Hospital outpatient. PARTICIPANTS Thirty-two people with stroke (mean age 70 years) at least 3 months after stroke, and 32 healthy, age-matched controls (mean age 70). MAIN OUTCOME MEASURES Roughness discrimination thresholds were quantified utilizing acrylic foot plates, laser cut to produce graded spatial gratings. Stroke participants were tested on three occasions, and by two different raters. Inter- and intrarater reliability and agreement were evaluated with Intraclass Correlation Coefficients and Bland-Altman plots. Convergent validity was evaluated through Spearman rank correlation coefficients (rho) between the FoRDT and the Erasmus modified Nottingham Sensory Assessment (EmNSA). RESULTS Intra- and interrater reliability and agreement were excellent (ICC =0.86 [95% CI 0.72-0.92] and 0.90 [95% CI 0.76-0.96]). Discriminant validity was demonstrated through significant differences in FoRDT between stroke and control participants (P < .001). Stroke fallers had statistically significant higher FoRDT scores compared with nonfallers (P = .01). Convergent validity was demonstrated through significant and strong correlations (rho) with the Erasmus MC Nottingham Sensory Assessment (r = .69, P < .01). Receiver operator characteristic curve analysis indicated the novel test to have excellent sensitivity and specificity in predicting the presence of self-reported sensory impairments. Functional Reach test significantly correlated with FoRDT (r = .62, P < .01) whereas measures of postural sway and gait speed did not (r = .16-.26, P > .05). CONCLUSIONS This simple and functionally oriented test of plantar sensation is reliable, valid, and clinically feasible for use in an ambulatory, chronic stroke and older population. It offers clinicians and researchers a sensitive and robust sensory measure and may further support the evaluation of rehabilitation targeting foot sensation. LEVEL OF EVIDENCE III.
Collapse
Affiliation(s)
- Terry Gorst
- School of Health Professions, University of Plymouth, Plymouth, UK
| | - Jenny Freeman
- School of Health Professions, University of Plymouth, Plymouth, UK
| | - Kielan Yarrow
- Department of Psychology, City, University of London, London, UK
| | - Jonathan Marsden
- School of Health Professions, University of Plymouth, Plymouth, UK
| |
Collapse
|
9
|
Woo MT, Davids K, Liukkonen J, Orth D, Chow JY, Jaakkola T. Effects of different lower-limb sensory stimulation strategies on postural regulation-A systematic review and meta-analysis. PLoS One 2017; 12:e0174522. [PMID: 28355265 PMCID: PMC5371369 DOI: 10.1371/journal.pone.0174522] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2016] [Accepted: 03/10/2017] [Indexed: 11/23/2022] Open
Abstract
Systematic reviews of balance control have tended to only focus on the effects of single lower-limb stimulation strategies, and a current limitation is the lack of comparison between different relevant stimulation strategies. The aim of this systematic review and meta-analysis was to examine evidence of effects of different lower-limb sensory stimulation strategies on postural regulation and stability. Moderate- to high- pooled effect sizes (Unbiased (Hedges’ g) standardized mean differences (SMD) = 0.31–0.66) were observed with the addition of noise in a Stochastic Resonance Stimulation Strategy (SRSS), in three populations (i.e., healthy young adults, older adults, and individuals with lower-limb injuries), and under different task constraints (i.e., unipedal, bipedal, and eyes open). A Textured Material Stimulation Strategy (TMSS) enhanced postural control in the most challenging condition—eyes-closed on a stable surface (SMD = 0.61), and in older adults (SMD = 0.30). The Wearable Garments Stimulation Strategy (WGSS) showed no or adverse effects (SMD = -0.68–0.05) under all task constraints and in all populations, except in individuals with lower-limb injuries (SMD = 0.20). Results of our systematic review and meta-analysis revealed that future research could consider combining two or more stimulation strategies in intervention treatments for postural regulation and balance problems, depending on individual needs.
Collapse
Affiliation(s)
- Mei Teng Woo
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
- School of Sports, Health and Leisure, Republic Polytechnic, Singapore, Singapore
- * E-mail:
| | - Keith Davids
- Centre for Sports Engineering Research, Sheffield Hallam University, Sheffield, United Kingdom
| | - Jarmo Liukkonen
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| | - Dominic Orth
- Faculty of Behavioral and Movement Sciences, Vrije Universiteit Amsterdam, Amsterdam, Netherland
| | - Jia Yi Chow
- Physical Education and Sports Science, National Institute of Education, Nanyang Technological University, Singapore, Singapore
| | - Timo Jaakkola
- Faculty of Sport and Health Sciences, University of Jyväskylä, Jyväskylä, Finland
| |
Collapse
|